Kanner, AM, Epilepsy & Behavior 61 (2016);282-286.

Purpose

Many people are concerned that all antidepressant medications can trigger seizures or make them worse. As a result, these medications may not be used appropriately to treat depression in people with epilepsy. Since depression can occur in 30 to 50% of people with epilepsy, understanding the safety of antidepressant drugs is critical.

Description of Study

In this review study, Dr. Andres Kanner discusses information from studies in people and animals about the risks of antidepressant drugs. The article examined data about the risks of antidepressant medications causing or triggering seizures and whether they may actually lower seizure frequency in some people with epilepsy.

Summary of Study Findings

  • Data from earlier studies that reported seizures from antidepressant drug use found that seizures occurred only at very high doses (e.g., overdoses) in all except four drugs. Some animal studies have found similar results.
  • Studies about the use of antidepressant medications are complicated by the finding that people with depression appear at greater risk of seizures. If a person with depression taking an antidepressant medication has a seizure, there may be a biological reason for the seizure.
  • This review found that most antidepressant drugs at appropriate doses are safe for people with epilepsy. Information on four medications showed a higher risk of causing seizures:  clomipramine, bupropion, amoxapine, and maprotiline.
  • Other causes of depression and anxiety need to be evaluated before treating a person with an antidepressant. Some mood changes may be related to the epilepsy or due to a side effect or change in a seizure medication.
  • Ways to use antidepressants when treating people with epilepsy and interactions between some seizure medications and antidepressants were reviewed.

What does this mean?

  • People with seizures and epilepsy who have changes in mood should be evaluated to diagnose the cause.
  • If a person is diagnosed with depression, it’s important to treat it early, just like it’s important to treat epilepsy as early as possible.
  • Most antidepressants do not cause seizures and can be used in people with epilepsy when prescribed and taken at the right doses.
  • Seeing an epileptologist (epilepsy specialist) and a neuropsychiatrist (psychiatrist specializing in neurological problems) may be helpful if problems diagnosing or treating depression, anxiety, or other mood changes persist.
  • Learn more about epilepsy, mood and behavior.

Article published in Epilepsy & Behavior, August 2016

Authored By: 
Patty Obsorne Shafer RN, MN
Authored Date: 
08/2016
Reviewed By: 
Joseph I. Sirven MD
on: 
Monday, August 29, 2016